April 29, 2008 - HAIR update (and I don't mean the musical)

Sorry for the delay in updating my blog. Life is really stressful when you lose your cable modem. I don't recommend it to anyone. What? No Internet? I need it like I need air, I'm finding.

I said I was gonna do it, and I did it. Aaaaaaaaaaaaaaaaaaaaaa. Well, Kristi did it, but I let her. (Thanks Kristi! You're a doll!) I had her cut my hair really short. I feel very different. I'm glad I did it, but I was just a tid bit freaked out at first. I woke up on Monday, and I had an urge to wear animal print. So I donned my cheetah skirt, and I went into work for a quick meeting on Monday. As I arrived, I found myself trying to hide from myself. Everywhere I went, there I was. Most said they like it; A couple of folks got really big-eyed and did a double-take. My son just asked when I was gonna have long hair again. Christmas-time is about the earliest (if I even decide to go long again!) Many have asked if I'm sure I'll lose my hair. My oncology nurse said that in 30 years, she hasn't seen a single patient that didn't lose their hair, so why not take some risks while I have a couple of weeks to mess around with it?

Two days later, I'm comfortable with my hair, and I like it. No more 40-minute hair prep. Whooo-ya!

On another topic - we celebrated my sister-in-law (Karla's) 50th birthday on Saturday..... a family event we had planned long before my cancer diagnosis. We had Clayton and Karla's cousins here from LA and Karla's God parents from Encinitas, along with other family and friends. We kept it small for Karla's sake. Large groups often cause her to have seizures, but she did well and enjoyed her party. Clayton and Cassie, with some help from others, did all of the cooking and cleaning. I just sat back and enjoyed the day. My stomach hasn't been feeling too well, and I've lost 6 lbs over the last week. The doc gave me some stuff to settle my tummy, and I already feel better. So maybe this 2-week chemo cycle will mean a slightly rough first week and a better second week. Time will tell.

I'll attempt to attach a picture of my new hair to this blog. Thanks for reading.

- Sandy

April 24, 2008 - Getting through Days with Chemo

Things are going along smoothly. I took Parker to work with me today for Bring a Child To Work Day. He had a blast shooting water balloons at a target (and hitting BOTH targets), watching The Dream is Alive video (about shuttle launches and astronauts in space). And he got to meet Goose, the explosive-detecting dog (who even impressed me). Parker said it was 'the best day ever'. I'm so thankful that my workplace sponsors such an important event. At about 1:30, I was tuckered, so we went home, and I took a nap for an hour or so.

I have a few issues with food tasting a little different, but all in all, my appetite is up and I'm able to continue to function normally. Life is good.

Thanks for reading!

- Sandy

April 22, 2008 - Day After First Chemotherapy Treatment

Thanks for the love and prayer chains. They keep comin, and I love it. You're the breast! (My new saying.)

I started feeling pretty nauseous last night. Dinner was a light one. Cassie picked up my 'just in case' prescription.....ya know the one 'just in case' the other tons of nausea meds I already had didn't work. The nausea subsided for about an hour, and then it was back. I decided to go to bed at 8:30, even though my nurse told me I probably wouldn't sleep much the first night.

I put my toothbrush in my mouth, and before I even started brushing, my nausea was completely GONE. Strange. Must have been one of those prayers answered. Yay. Thanks! Oh, and I slept like a baby. :-)

Went to work today for 1/2 day only, because I have a doctor appt at 2:15. Felt just fine while I was there.

April 21, 2008 - Chemo and Sandy Meet for the First Time

Chemo is my friend. It's got some baaaaaaaad stuff in it, but the good stuff is going to help me more than the bad stuff is going to hurt me, so .... chemo is my friend.

We got there at 11 am. Vanessa put the first IV in just fine (painfully, but fine), and then no blood would come out, so she had to call in an expert to choose another vein. Jill showed up and within a minute or so, we were in business. After 3 types of anti-nausea drugs, 2 types of chemo, and lots of saline, I finished at 2:30.

I feel fine. We'll see what each new day brings. I plan to attack every day like I didn't have chemo.

My sweet hair girl, Kristi, called tonight to see how I was doing. I told her I wanted to cut my hair off and donate it to Locks of Love. She offered to drive 30 miles to my house on her day off to cut my hair. WHAT A DOLL! errrr.... I mean.... She's the breast! So, Sunday I'll have really short hair. I haven't had really short hair since my pixie cut in 4th grade. :-) Hmmm... I should post that photo.

My Support System

I feel so blessed to have the family and friends that I have. I wish everyone who experienced a cancer diagnosis had the same outpouring of love and caring that I've already received. My family and friends call often and are constantly asking what they can do to help. My husband is the BEST ever. I knew I'd always be in good hands with him when I watched him care for his mother during her illness. He is the most loyal man I have ever known, and I feel so blessed to be married to him. My ten year old is as sweet as can be, and my step-daughters and sister-in-law are there for me everyday.

My management and co-workers have said they are willing to help in any way they can, and that means so much. (Being on the Space Shuttle team is like being a part of a huge family.) I've gotten calls from friends I've been out of touch with, and I've received gifts from people I've never met. A few of my family and friends have cried when I talk to them, and I assure them I will be fine. (Cuz I will be, darn it. It is just so!)

What can anyone do to help? Hmmmmmm..... How about some cute nicknames when my hair is gone... names that say one thing, but mean another... like "Cutie" (hidden meaning: cue-ball head), or"Birdie" (hidden meaning: bald eagle). Or you can give me the nickname, and let me guess the hidden meaning. :-)

April 18, 2008 - Treatment Plan

We met with Dr. VanderMolen today. He went over the results of yesterday's testing, and everything is within normal range, except for some spots on my lungs that appear to be scar tissue. He'll run another scan in 3 months to verify there's been no change. We will assume it's scar tissue, since I had surgery (thorocotomy) on my left lung in 83 and my right lung in 84. My heart function is slightly better than average. Nice!

I didn't realize it until today that I was still confused about why I needed further testing. I thought that "No lymph node involvement" meant that it hadn't spread. He said (and don't quote me on this) that means it hadn't spread via the lymph nodes, but that it had a chance of spreading through the blood stream. He read on my pathology report where it said "LYMPHOVASCULAR INVASION: PRESENT". I think he said that meant it was in my bloodstream. (Glad I got that cleared up. Apparently I'm still confused!)

He explained why the TC treatment isn't enough for me. He said it's good for women whose tumors are hormone receptor positive, because they can follow up with hormonal therapy. I cannot follow up chemo with hormonal therapy because my hormone receptors, estrogen and progesterone, and the gene Her-2/neu were negative.

I will do four weeks of AC, and if the cancer cells become immune to the AC, they certainly won't be immune to the Taxol (T) that will follow the AC. He says I'll have a 95% or better cure rate with this treatment.

Dr. VanderMolen then introduced me to Jackie, who after 30 years of being an oncology nurse, has seen it all. I am in very good hands here. Jackie asked me what I understood about the treatment and then she explained everything (treatment times, methods, appointments, side effects, places to buy a wig, etc.) in detail. Their treatment process includes about 4 different anti-nausea medicines so I can continue to hydrate myself. Now I just need to remember why hydration is so important.

I go back the day after chemo to get a shot of Neulasta (Yes. Like you hear on the commercial. "I'm ready. I'm ready for my next chemotherapy treatment.") Then every week I get a complete blood count to test my white blood cell count, my red blood cell count and my platelet count.

I'll start chemo on Monday at 11 am. Radiation follows after 4 months of chemo. I feel like I'm about to get on a horse that will start bucking, but I plan to hang on tight.

April 17, 2008 - Testing

Had a series of tests run today. CT Scan (got to drink the berry potion - yum!); Bone scan (got an injection 3 hours before); and echocardiogram. I'll meet with the oncologist tomorrow to go over the results.

April 17, 2008 - Oncology Opinions

I sent an email yesterday to friends and family that know about my diagnosis. I received many sweet responses, and I wanted to reply to all of them, but with testing and work and baseball and ..... etc..... Well, I feel overwhelmed right now....I realized I had better start a blog to capture my thoughts and keep people informed that have an interest in knowing about my journey.

I had seen a doctor in Fountain Valley last week for my first oncology opinion, and I adored him and his office staff, and I really thought I would do further treatment with him. I read the book, THE BREAST CANCER SURVIVAL GUIDE, and I got lots of info from it. I felt confident that, by reading this book, I understood my pathology report before I even saw him. The book taught me that I'd need chemo, which made the doctor's news easier to take. He set me up for a teaching to learn about chemo. I was to get the chemotherapy combination "TC" for 6 treatments, one every 2 to 3 weeks. I scheduled the teaching class for the day after I was to see the next doctor.

My husband and I figured we'd probably get the same info from the 2nd doctor, but that didn't happen. Dr. VanderMolen (at Hoag) asked what had transpired medically since my 3/18 surgery. I had nothing to say, except for the follow-up with my surgeon. He asked about testing to check for further spread (via CT Scan, bone scan, etc.). He went over things in detail, and we felt more confident with his plan. We will go with Dr. VanderMolen, even though the chemo regimen is a bit more intense. The regimen scheduled now is AC for 4 cycles, one every two weeks, and Taxol (T) for 4 cycles, one every two weeks.

Both doctors seemed really good at what they do, but something scared me about the fact that the first doctor didn't order any tests (CT scan, bone scan, etc.). The new doctor wants to understand the total body situation.

Here's the email I sent after my 2nd oncology opinion:

Hello. You've received this email because you already know about my breast cancer diagnosis. If you're uncomfortable receiving this type of info, please let me know, and I won't send anything further. I look at these types of things with an "it is what it is" attitude, so I will deal with the diagnosis and treatment and try to understand it as much as possible.

I had my 2nd oncology opinion today. The first doctor had recommended 6 chemo treatments, followed by radiation. Chemo treats systemic spread and radiation treats local microscopic cancer cells around the area of the surgery. I think everyone needs a second opinion, so I scheduled one at Hoag. It was a little rough talking with a doctor that "doesn't do 2nd opinions", but once we got past that little argument, Clayton and I learned a LOT from Dr. VanderMolen.

I thought I understood my pathology report pretty well until he explained it in detail. It was kind of fascinating. (I know. I'm strange.) He went through the good and bad.... * No lymph node involvement (good). * Both hormone receptors (progesterone and estrogen) were negative, so they cannot treat me with hormone therapy (not good). * Tumor size was 1.8 cm (not good). Under 1 cm considered good. Still at Stage I, though. * Proliferation rate was extremely high (not good and most worrisome factor). The first doc told me these cells divide about every 40 days. * Her-2 Neu, a gene, was low (good). With that, Dr. VanderMolen wants to do chemo and radiation after a series of tests (CT Scan, Bone Scan, and Echocardiogram), which are all scheduled for Thursday. The first doctor scheduled no tests. When breast cancer spreads, it spreads to the liver, the lungs, and the bones, so he is using the CT and Bone scans to check for macroscopic cells that might be present. The echocardiogram will test my heart to make sure it's strong enough for the chemo treatments. He informed me that chemo should start as soon as 1 month after surgery, so I should start chemo on Monday. He also said the treatment the other doctor had recommended was not appropriate for my particular situation, and he thought I had a pretty good chance of relapse in 2 to 3 years if I was to choose that option. Instead of 6 chemo treatments, I'll now do 8 treatments over four months. And yes - I will temporarily lose my hair - a small price to pay for a longer life. I always wondered what I'd look like with short, spiky hair, and now I get to find out (with an excuse)!

So - now I've joined the ranks of the 1 in 9 women with breast cancer. I hear it's not a fun experience, but it's HIGHLY treatable, and I will get through this just like other women do. I thank God for the thousands and thousands of women who went before me to test the treatments that are available today. Please have all the women you know do self exams. I had my mammogram in October, and I found the aggressive lump on my own in January. I didn't do regular checks because with all the lumpy stuff already present, I didn't think I'd notice anything different. It was a freak thing that I found it. I'm not shy about talking about it, and I don't mind who knows, but I am a bit self conscious about wearing no make-up, so I can imagine I won't want to show up too many places with no hair. I won't miss one of my son's baseball games for anything, though! They are in first place (7-1). Woo hoo! Thanks for letting me share.

Update at end of season: The team took 2nd place overall and got some cool trophies. :-)

January 2008 - Finding a Lump, Then Surgery

January 15-ish..... After years of delay, I finally set goals to better myself, and I started working out. After a few circuit training classes and various other workouts, I was pretty sore. As I was massaging my sore muscles, I felt a lump in my right breast near my armpit, but only when my right arm was stretched backward. Hmmmm. Nothing on the left side. Strange, but it's probably nothing, I thought. I couldn't feel the lump when my arm was relaxed, so it must not really be there.

A few weeks went by, and on occasion, I would stretch my arm back, and there was the lump. It felt larger than a pea, but smaller than a cherry. I finally decided to call the doc and schedule an appt. When the receptionist said "come in NOW", I thought.....could it be that urgent? My better judgement told me to cancel a luncheon I had planned to attend and go to the doctor's office. She couldn't even feel the lump, but thought it should get checked anyway, so she sent me to get a mammo, an ultrasound, and a needle biopsy, if needed.

By the way, I had just had a mammo 4 months earlier, in October of 2007. I remember the girl telling me how excited she was that in November they would be moving to digital technology.

On 2/27/08, at 9:00 am., I checked into Total Care in Los Alamitos. If you want efficiency, these guys have their crap together. By 10:30, I had a mammo, and ultrasound and a needle biopsy. I was expecting them to find nothing with the ultrasound, but unfortunately, they did, and so the needle biopsy was needed.

I was supposed to get results from the biopsy in about 3 days. Since it was a Wednesday morning, I figured I might get lucky and have the results by Friday. I finally got the results on Monday late afternoon. They didn't take enough tissue (translated ... the needle was not working properly), so I had to go back and have the biopsy done again on Wednesday. There goes a week and a lot of wondering. I had a routine appt scheduled for Thursday, 3/6 with my doc, and she demanded preliminary results from the pathologist. 24 hours after the 2nd biopsy, the doc had preliminary results. The news wasn't good. Invasive ductal carcinoma (IDC). Fortunately the tumor was small, so I was relieved to hear I was at Stage I.

I met with a couple of great surgeons, and I ended up choosing Dr. Melvin Silverstein at Hoag. He was literally in his first week at Hoag when I met with him, but his track record was phenomenal. He is world-renowned in breast cancer treatment and research. He had just moved from USC to run the Breast Care Center at Hoag. Great, great man. (See how God is lining everything up for me?)

I had surgery (lumpectomy and sentinel node biopsy) on 3/18/08. This is what I sent in an email the day after surgery:

Good news with yesterday's surgery. The doc removed the 1.8 cm tumor, and the sentinel lymph node biopsy showed that the cancer had NOT spread to the lymph nodes. Yay! I'll see him on Monday for review of the pathology report and news of further treatment. Everything I've heard from the doctors and read in books says I'll have to have radiation treatment, but that's ok. I'll do whatever has to be done to make sure it's all gone.

When I woke up in recovery yesterday, the first thing out of my mouth was "These bandages are too tight, and I can't breathe." The doc had ace-type bandages wrapped around me so tight (to reduce bruising) that I felt like my ribs were overlapping each other. I thought I had experienced tightness in my chest before, but nothing compared to that. The doc came back and re-bandaged me (instant relief). The nurse said my pulse went from 114 to 102 after the bandage change. I told her relieve the 'transporter guy', as I was ready to walk down to my next destination. She said "Wow. Do you want to help us lift this patient, too?" Typically I don't enjoy myself in the recovery room, but I felt SO MUCH BETTER after the rebandage.

Today I'm doing well. No real pain to speak of, just some soreness in the sternum area (as the 2nd set of bandages are still a little tight). I should be back to work Thursday or Friday. Thanks for all the prayers and well-wishes. Have your loved ones do their self-exams! I rarely did, because I thought I wouldn't be able to notice anything different. After finding something questionable, the thought might be that it's nothing, but get it checked! Better safe than sorry. I've heard numerous stories of women waiting too long to pursue a lump.

Thought I'd throw in a couple of pics of me.....

Me and my grandsons, Joe and Ryan in 2007....

April 2008....